十二指腸閉塞を伴う左心症の2例

概要

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Two patients with Ievocardia were encountered, presenting with bile-stained vomiting. One is a 3 year-old acyanotic boy and the other a 4 day-old cyanotic male neonate. Upright plain X-ray films of the chest and abdomen showed the heart to be situated in the left hemothorax, while the gastric bubble below the right diaphragm. As a double bubble sign was seen in both cases, these patients were explored for duodenal obstruction. The stomach and spleen were present in the right and the liver in the left side in both cases. Duodenal obstruction was due to malrotation with volvulus in one case and due to membranous stenosis with malrotation in the other. These patients were successfully operated on by release of volvulus with division of the Ladd's band and duodenoduodenostomy, respectively. The subsequent postoperative course was uneventful in both cases. Postoperative cineangiography of the heart revealed no intracardiac anomalies in one patient but a common ventricle with pulmonary atresia and a patent ductus arteriosus were seen in the other. This paper summarizes our experience of two cases of duodenal obstruction in situs inversus with levocardia and an analysis of associated anomalies of abdominal viscera from eighteen collected cases is discussed.
日本小児外科学会の論文
1980-06-20